Abstract
Obstructive sleep apnea in children has been linked with behavioral and neurocognitive problems, impaired growth, cardiovascular morbidity, and metabolic consequences. Diagnosing children at a young age can potentially prevent significant morbidity associated with OSA. Despite the importance of taking a comprehensive sleep history and performing thorough physical examination to screen for signs and symptoms of OSA, these findings alone are inadequate for definitively diagnosing OSA. In-laboratory polysomnography (PSG) remains the gold standard of diagnosing pediatric OSA. However, there are limitations related to the attended in-lab polysomnography, such as limited access to a sleep center, the specialized training involved in studying children, the laborious nature of the test and social/economic barriers, which can delay diagnosis and treatment. There has been increasing research about utilizing alternative methods of diagnosis of OSA in children including home sleep testing, especially with the emergence of wearable technology. In this article, we aim to look at the presentation, physical exam, screening questionnaires and current different modalities used to aid in the diagnosis of OSA in children.
Highlights
The prevalence of obstructive sleep apnea (OSA) is difficult to obtain in the pediatric population, the current literature reports rates of about 0.7% to 13% [1]
The pediatric population presents differently compared to adults when sleep quality is disturbed and is less likely to present with daytime sleepiness revealed by Gozal et al In this paper, only 7 out of 54 pediatric OSA patients presented with sleepiness [13]
This study showed the potential of portable monitors (PM) for screening pediatric OSA patients and may provide alternative method of diagnosis [37]
Summary
The prevalence of obstructive sleep apnea (OSA) is difficult to obtain in the pediatric population, the current literature reports rates of about 0.7% to 13% [1]. Wide the distribution of prevalence may be, it has been well established that OSA, a form of Sleep Related Breathing Disorder (SRBD), can lead to gas exchange abnormalities along with fragmented and insufficient sleep. There is evidence in the literature that untreated OSA in children is associated with behavioral and neurocognitive problems, impaired growth and in the long run can lead to cardiovascular and metabolic consequences. Setting aside the health risks associated with OSA in pediatrics, the social consequences can be very burdensome with disturbances in familial, education, and psychological development of the child. Given the physical and psychological detrimental effects of OSA, it is becoming more apparent that early and adequate diagnosis is imperative in the hopes of preventing long term sequelae
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